肺癌的诊断与预测性免疫细胞化学
Diagnostic and Predictive Immunocytochemistry in Lung Cancer.
作者信息
Jain Deepali, Satapathy Shraddhanjali, Bubendorf Lukas
机构信息
Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland.
出版信息
Acta Cytol. 2025;69(1):69-76. doi: 10.1159/000541478. Epub 2024 Sep 19.
BACKGROUND
Immunocytochemistry (ICC) is suitable for use on a range of cytology preparations, such as cell blocks, air-dried slides, ethanol-fixed slides, direct smears, cytospins, and liquid-based cytology (LBC) samples. However, it must be standardized against the gold standard of formalin-fixed paraffin-embedded tissues with adequate number of positive and negative controls. The role of ICC in lung cancer is crucial, as most lung cancer specimens are cytology samples. Accurate diagnosis and testing of certain biomarkers rely heavily on both diagnostic and predictive ICC.
SUMMARY
Key ICC markers important in lung cancer include, but are not limited to, diagnostic ICCs such as TTF-1, p40, Napsin A, and p63, as well as predictive ICCs like ALK, ROS-1, PD-L1, and NTRK.
KEY MESSAGES
With proper validation, immunocytochemistry for lung cancer can be effectively performed on direct smears, cytospins, and other specimens, even when resources for preparing cell blocks are unavailable. This is particularly true for diagnostic antibodies, but it is important to exercise caution with predictive ICC. Nonetheless, a low threshold for molecular testing should be maintained. PD-L1 ICC can be challenging and should ideally be performed on formalin-fixed cell blocks or biopsies when available.
BACKGROUND
Immunocytochemistry (ICC) is suitable for use on a range of cytology preparations, such as cell blocks, air-dried slides, ethanol-fixed slides, direct smears, cytospins, and liquid-based cytology (LBC) samples. However, it must be standardized against the gold standard of formalin-fixed paraffin-embedded tissues with adequate number of positive and negative controls. The role of ICC in lung cancer is crucial, as most lung cancer specimens are cytology samples. Accurate diagnosis and testing of certain biomarkers rely heavily on both diagnostic and predictive ICC.
SUMMARY
Key ICC markers important in lung cancer include, but are not limited to, diagnostic ICCs such as TTF-1, p40, Napsin A, and p63, as well as predictive ICCs like ALK, ROS-1, PD-L1, and NTRK.
KEY MESSAGES
With proper validation, immunocytochemistry for lung cancer can be effectively performed on direct smears, cytospins, and other specimens, even when resources for preparing cell blocks are unavailable. This is particularly true for diagnostic antibodies, but it is important to exercise caution with predictive ICC. Nonetheless, a low threshold for molecular testing should be maintained. PD-L1 ICC can be challenging and should ideally be performed on formalin-fixed cell blocks or biopsies when available.
背景
免疫细胞化学（ICC）适用于一系列细胞学标本，如细胞块、空气干燥涂片、乙醇固定涂片、直接涂片、细胞离心涂片和液基细胞学（LBC）样本。然而，必须以福尔马林固定石蜡包埋组织的金标准为对照进行标准化，并设置足够数量的阳性和阴性对照。ICC在肺癌中的作用至关重要，因为大多数肺癌标本都是细胞学样本。某些生物标志物的准确诊断和检测在很大程度上依赖于诊断性和预测性ICC。
总结
在肺癌中重要的关键ICC标志物包括但不限于诊断性ICC，如甲状腺转录因子-1（TTF-1）、p40、 napsin A和p63，以及预测性ICC，如间变性淋巴瘤激酶（ALK）、ROS-1、程序性死亡配体1（PD-L1）和神经营养酪氨酸激酶受体（NTRK）。
关键信息
经过适当验证后，即使没有制备细胞块的资源，也可以在直接涂片、细胞离心涂片和其他标本上有效地进行肺癌免疫细胞化学检测。对于诊断性抗体尤其如此，但对预测性ICC进行检测时必须谨慎。尽管如此，仍应保持较低的分子检测阈值。PD-L1 ICC可能具有挑战性，理想情况下，如有福尔马林固定的细胞块或活检标本，应使用它们进行检测。
背景
免疫细胞化学（ICC）适用于一系列细胞学标本，如细胞块、空气干燥涂片、乙醇固定涂片、直接涂片、细胞离心涂片和液基细胞学（LBC）样本。然而，必须以福尔马林固定石蜡包埋组织的金标准为对照进行标准化，并设置足够数量的阳性和阴性对照。ICC在肺癌中的作用至关重要，因为大多数肺癌标本都是细胞学样本。某些生物标志物的准确诊断和检测在很大程度上依赖于诊断性和预测性ICC。
总结
在肺癌中重要的关键ICC标志物包括但不限于诊断性ICC，如甲状腺转录因子-1（TTF-1）、p40、 napsin A和p63，以及预测性ICC，如间变性淋巴瘤激酶（ALK）、ROS-1、程序性死亡配体1（PD-L1）和神经营养酪氨酸激酶受体（NTRK）。
关键信息
经过适当验证后，即使没有制备细胞块的资源，也可以在直接涂片、细胞离心涂片和其他标本上有效地进行肺癌免疫细胞化学检测。对于诊断性抗体尤其如此，但对预测性ICC进行检测时必须谨慎。尽管如此，仍应保持较低的分子检测阈值。PD-L1 ICC可能具有挑战性，理想情况下，如有福尔马林固定的细胞块或活检标本，应使用它们进行检测。
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